Every day I experience life in the world of healthcare IT, supporting 3000 doctors, 18000 faculty, and 3 million patients. In this blog I record my experiences with infrastructure, applications, policies, management, and governance as well as muse on such topics such as reducing our carbon footprint, standardizing data in healthcare, and living life to its fullest.

Tuesday, February 26, 2008

Dispatch from HIMSS

I'm at HIMSS for 24 hours. For those who want say hello, I'm keynoting the Electronic Health Record Vendor's Association Breakfast from 7am to 8am in Convention Center Room 240D, keynoting the HITSP Town Hall from 8:30am-9:30am in Convention Center Room 204C, then meeting with several groups on the Exhibition floor until my plane departs back to Boston in the afternoon.

Here are a few observations from my hallway discussions at HIMSS thus far

1. Personal Health Records have gone mainstream . With Microsoft's Healthvault, Revolution Health, Dossia, and anticipated announcements from Google, it's clear that patients will have many options to become stewards of their own healthcare data. The next step will be for labs, pharmacies, payers, clinics and hospitals to provide standards-based connections to these personal health records. Now that Secretary Leavitt has recognized the national standards for personal health records, there should be convergence on the use of the continuity of care document for personal health record interoperability.

2. Personal Health Records will accelerate Health Information Exchange efforts. Health Information Exchanges and RHIOs have faced many challenges, including funding for central infrastructure and privacy concerns. Personal Health Records which enable the patient to move records from place to place are peer to peer, and use the free infrastructures provided by Microsoft, Google et al. Since the patient does the transfer, there are no HIPAA business associate agreements or covered entity issues. The patient is in full control of who sees what and when.

3. Electronic Health Records and Computerized Provider Order Entry are now seen as essential. Hospitals realize that Joint Commission accreditation, pay for performance programs, care coordination efforts, and quality measurement require these technologies. They are committed to making the investments. Of course there are still issues with rural hospitals and solo practioners, but the larger organizations have passed the tipping point.

4. Interoperability is being taken seriously. At the Interoperability Showcase, the IHE Theater, the EHRVA meetings, and throughout the Exhibition floors, I'm hearing about the possibilities of using the standardized patient summaries for EHR, PHR, Quality, Public Health, and clinical research. The next year should see significant adoption of these new standards. Here's an overview of all the interoperability events at HIMSS.

5. Security is increasingly a focus of many CIOs. Several states, such as Massachusetts and California have new data protection compliance and reporting requirements. Intrusion detection and prevention technologies are hot.

6. Storage and archiving technologies are become more sophisticated and lower cost. Healthcare CIOs are faced with storing more images and other data, so having easy to manage enterprise class storage and archiving is key.

7. Software as a service/ASP models are increasingly popular as a means to reduce total cost of ownership and ease deployment.

8. New mobile devices for clinicians have longer battery life, larger screens and lighter weight. PDAs are vanishing. Small form factor tablets/laptops are growing.

9. Collaboration tools for virtual teams are growing in popularity as local healthcare IT expertise becomes hard to find and retain.

10. Open Source is finding its way into the healthcare data center, with Linux providing the server side operating system support for Oracle databases, MySQL, and numerous vendor supported appliances.